TO REGULATE STEP THERAPY AND FAIL FIRST PROTOCOLS CONCERNING CERTAIN PRESCRIBED VENTILATORS.

segalco.com PURPOSE OF BILL: HB 1321 To regulate step therapy and fail first protocols concerning certain prescribed ventilators. ACTUARIAL STATEMENT The Fiscal Impact Statement was prepared according to generally accepted actuarial principles and practices, in compliance with ACT 112. The Statement provides an estimate of the financial and actuarial effect of the proposed change(s) on the Plans, if possible. The Statement makes no comment or opinion with regard to the merits of the measure for which the Statement is prepared; however, any identified technical or mechanical defects have been noted. We have reviewed the input and results of our analysis for reasonableness and relied upon the data and information provided by the Plans and their Claims Processing Contractors. 3/12/2025 _________________________________________ _________________ Patrick Klein, FSA, MAAA Date Vice President, Segal 3/12/2025 _________________________________________ __________________ Matthew Kersting, FSA, MAAA Date Vice President, Segal PROJECTED COSTS Plan Design Change Estimated Cost/(Savings) Plan EBD No Change No Impact PRICING APPROACH AND COMMENTS House Bill 1321 prohibits step therapy and fail f